Friday, April 8, 2016
Being Fired
I have to admit I was not sure if I would share these stories but I feel as a leader we are always faced with the possibility that our performance does not meet or match what a company may expect from us. First I want to share my encounters with being fired. Yes I am admitting it and hope that I learned and have grown from them. I was actually terminated twice in my 40 year career. They were about 20 years apart.
The first time that I was fired I was a director of nursing in a small nursing home. I had worked there for 3 years. The company I worked for had 5 facilities. During that time I had developed a good team and had good results for surveys. This was just as OBRA was coming into play. During this time I worked for 3 different administrators. I had what I thought was a good relationship with the owners. I was actually sent to some of their other facilities. In 1 capacity I did the CPR training for our other facilities and I also covered as the director of nursing. Shortly after the third administrator started he came to me and said something like I have evaluated your services and we are going to let you go. He asked if he could pull my car up and got me a box for my things. Being a small facility I had to go by everyone and told one of my nurses I was leaving and wouldn't be back. She looked at me and said stop pulling my leg. I told her I wasn't and then broke down and cried. I left quickly and quietly and never looked back. I never was quite sure what happened but after a bit of searching I found work as a part time supervisor in a larger facility with a larger company. I was always honest about what had happened.
The second time I was terminated was less than 2 years ago. I had been doing independent contract work for over 1 year and loved it. Unfortunately my husband developed colon cancer and I had to find work that offered insurance. I became the administrator in a larger facility with a large corporate organization. During my time there I had a complaint survey almost monthly related to a disgruntled resident. I had 4 different regional directors. Was sent to help with yet another problem facility to help with their follow up survey. My building was census challenged therefore financially challenged. The last regional I had brought on a great regional nurse as well. I really felt like we were going to finally start seeing improvement. I had to fire several nurses for poor performance during this time but felt we had finally started to turn the corner. During the last few weeks I was employed I worked 10-12 hours per day 5-7 days per week and was starting to feel beat down a bit.
I remember the night before I was fired I felt like I got a second wind and had written up a plan and assignments to go over with my team. When I arrived that morning I asked the corporate nurse if she minded if I met with my team alone and she told me no. I guess I should have figured something was up. I then did my morning meeting and talked about goals and assignments. Again I should have figured something was up they were too quiet. I don't think they all knew but obviously some did. After the meeting I had someone to see me. The regional said they needed to talk to me and I asked if it could wait till I met with the people waiting on me and they said yes.
I met with my guests and then invited the regionals into my office. The regional vice presidents gave me a piece of paper to read. This paper said that I had basically caused the facility to loose money and failed to improve census and clear survey issues. I was told I could sign the paper or write up my resignation. They told me if I did that they would pay me my earned vacation days. Of course I wrote a resignation.
My parting was a little bit funny to me. They asked someone to get me a box for my stuff and they brought a giant box. I had driven my little car so loading it I knew was going to be a challenge. I stuffed everything in the box. The regional said he would carry it and did. I know it was super heavy and my car was so small. He managed to get it in the car after a little bit of a struggle.
Well that is how I ended up doing what I am now as a floating administrator and director of nursing for problem buildings.
Here is the irony for those 2 situations. The first building I was fired from became one of my facilities as a regional vice president and regional nurse. The second building I was fired from was where I was working when at that time a different company sent me to school to get my administrators license and paid 100% of my tuition. If I learned anything from this it was to never burn a bridge. I never did or will speak badly of either of those facilities. Every thing happens for a reason.
The first time that I was fired I was a director of nursing in a small nursing home. I had worked there for 3 years. The company I worked for had 5 facilities. During that time I had developed a good team and had good results for surveys. This was just as OBRA was coming into play. During this time I worked for 3 different administrators. I had what I thought was a good relationship with the owners. I was actually sent to some of their other facilities. In 1 capacity I did the CPR training for our other facilities and I also covered as the director of nursing. Shortly after the third administrator started he came to me and said something like I have evaluated your services and we are going to let you go. He asked if he could pull my car up and got me a box for my things. Being a small facility I had to go by everyone and told one of my nurses I was leaving and wouldn't be back. She looked at me and said stop pulling my leg. I told her I wasn't and then broke down and cried. I left quickly and quietly and never looked back. I never was quite sure what happened but after a bit of searching I found work as a part time supervisor in a larger facility with a larger company. I was always honest about what had happened.
The second time I was terminated was less than 2 years ago. I had been doing independent contract work for over 1 year and loved it. Unfortunately my husband developed colon cancer and I had to find work that offered insurance. I became the administrator in a larger facility with a large corporate organization. During my time there I had a complaint survey almost monthly related to a disgruntled resident. I had 4 different regional directors. Was sent to help with yet another problem facility to help with their follow up survey. My building was census challenged therefore financially challenged. The last regional I had brought on a great regional nurse as well. I really felt like we were going to finally start seeing improvement. I had to fire several nurses for poor performance during this time but felt we had finally started to turn the corner. During the last few weeks I was employed I worked 10-12 hours per day 5-7 days per week and was starting to feel beat down a bit.
I remember the night before I was fired I felt like I got a second wind and had written up a plan and assignments to go over with my team. When I arrived that morning I asked the corporate nurse if she minded if I met with my team alone and she told me no. I guess I should have figured something was up. I then did my morning meeting and talked about goals and assignments. Again I should have figured something was up they were too quiet. I don't think they all knew but obviously some did. After the meeting I had someone to see me. The regional said they needed to talk to me and I asked if it could wait till I met with the people waiting on me and they said yes.
I met with my guests and then invited the regionals into my office. The regional vice presidents gave me a piece of paper to read. This paper said that I had basically caused the facility to loose money and failed to improve census and clear survey issues. I was told I could sign the paper or write up my resignation. They told me if I did that they would pay me my earned vacation days. Of course I wrote a resignation.
My parting was a little bit funny to me. They asked someone to get me a box for my stuff and they brought a giant box. I had driven my little car so loading it I knew was going to be a challenge. I stuffed everything in the box. The regional said he would carry it and did. I know it was super heavy and my car was so small. He managed to get it in the car after a little bit of a struggle.
Well that is how I ended up doing what I am now as a floating administrator and director of nursing for problem buildings.
Here is the irony for those 2 situations. The first building I was fired from became one of my facilities as a regional vice president and regional nurse. The second building I was fired from was where I was working when at that time a different company sent me to school to get my administrators license and paid 100% of my tuition. If I learned anything from this it was to never burn a bridge. I never did or will speak badly of either of those facilities. Every thing happens for a reason.
Thursday, March 31, 2016
Hiring Pains
I have been working in health care for 40 years with 30 of it in long term care. Yes, I know I'm too young to have worked that long, but I have. Well hiring has always been a difficult process but over the last few years it has gotten even more difficult. First of all the competition between healthcare settings is ruthless. With the reduction in our reimbursement, increase in expenses being creative and innovative in our hiring practices has become difficult.
I was recently working at a staffing challenged facility and trying to come up with ways to attract staff and get shifts covered. Well we offered a pick up a shift bonus to begin with. Next we increased it on the weekends. Then we started a referral bonus and then a sign on bonus. Before long we had STNA's making manager wages. We finally got a few STNA's hired on and about $25000.00 per pay more due to the incentives we were still running over 8% OT.
Our next attempt at improving staffing was to offer to send people to the nurse aide classes and pay their tuition. We had a lot of people interested and paid for 4 to go and at the end of the program only managed to maintain 1 at a cost of over $2000.00.
As soon as we started to feel a little better our competitor offered increased wages and a sign on bonus. Our current staff that were tired of working extra shifts were talking about jumping ship for what they felt was a better offer.
This problem is not only limited to line staff I have seen changes in how professionals and licensed staff approach the work force. I recently was looking for a DON in a facility and received 5 resumes on an online advertising program. I narrowed them down to 3 candidates. I made calls to all 3 and had to leave messages. I received a call from 1 and set up an interview. The other 2 did not call back and the 1 I set up an interview with did not show up or call. Another position I was filling the person had accepted the job and gave notice to their company and assured me they would not stay no matter what they offered. Less than a week before they were to start they called and said their old company gave them an offer they could not refuse. I have seen DON's walk off the job which was unheard of 10 years ago.
I would like to challenge people to tell me their opinion or ideas on getting and keeping staff.
I was recently working at a staffing challenged facility and trying to come up with ways to attract staff and get shifts covered. Well we offered a pick up a shift bonus to begin with. Next we increased it on the weekends. Then we started a referral bonus and then a sign on bonus. Before long we had STNA's making manager wages. We finally got a few STNA's hired on and about $25000.00 per pay more due to the incentives we were still running over 8% OT.
Our next attempt at improving staffing was to offer to send people to the nurse aide classes and pay their tuition. We had a lot of people interested and paid for 4 to go and at the end of the program only managed to maintain 1 at a cost of over $2000.00.
As soon as we started to feel a little better our competitor offered increased wages and a sign on bonus. Our current staff that were tired of working extra shifts were talking about jumping ship for what they felt was a better offer.
This problem is not only limited to line staff I have seen changes in how professionals and licensed staff approach the work force. I recently was looking for a DON in a facility and received 5 resumes on an online advertising program. I narrowed them down to 3 candidates. I made calls to all 3 and had to leave messages. I received a call from 1 and set up an interview. The other 2 did not call back and the 1 I set up an interview with did not show up or call. Another position I was filling the person had accepted the job and gave notice to their company and assured me they would not stay no matter what they offered. Less than a week before they were to start they called and said their old company gave them an offer they could not refuse. I have seen DON's walk off the job which was unheard of 10 years ago.
I would like to challenge people to tell me their opinion or ideas on getting and keeping staff.
Tuesday, June 16, 2015
Pre School Programs and Nursing Homes
I saw a wonderful video today about a nursing home that had a pre school program in the facility. The video showed the interaction between the children and the residents. One of the scenes involved a resident and child that was trying to put on her coat to go home.They were both having trouble and the resident told the child "I can't even do it". They touched, held hands and helped each other. It was absolutely heart warming. This is something I think all nursing homes should look into. Intergenerational programs are so wonderful. When my children were growing up they spent a lot of time in nursing homes. They did their trick or treating in nursing homes as well as Easter and Christmas programs. So many children do not get to have grandparents in their lives and the residents miss their children and grand children. Providing this type of program could only be a win win situation.
Tuesday, April 14, 2015
Responsivness
I am writing this post to honor some amazing people I have had the honor to work with. In any service field including health care, the key to success is being responsive. The following are a few incidents that exhibit what being responsive means:
A confused resident comes to the front lobby frequently in their wheelchair. The resident is always asking the same thing (I want to go home and see my mother). Usually the staff get the resident a cup of coffee and take them back to their room. One day I heard the residents familiar voice asking the question of the day (I want to go home to see my mother). I heard an employee say can you hold the door and I will take her for a wheelchair ride outside. This employee did not have to do that. They could have done the usual thing coffee and return them to the unit.
My facility had been going through the process of changing our facility focus which resulted in a sudden drastic reduction in residents. I was faced with the challenge of reducing staff. An employee came to me and told me the they would reduce their hours so their co-worker did not have to. The employee said that their co-worker did not have any other financial support and they did.
My last responsive story is about a maintenance man that is the best one I have ever known. He covers all maintenance duties for a large building that is 35 years old. One day I made rounds and discovered some potential infection control issues. I gave him a list that included replacing a sink and toilet, adding a sink to a utility room, a wall mounted cabinet to a utility room and putting new paper towel holders up in another utility room. I didn't give him the list till lunch time and he got all of it done in a couple of hours. This included going to the store to purchase sinks and cabinets. He also put all new mulch out and planted flowers in the courtyard without being asked.
I have seen many more incidents but these 3 really stood out for me.
A confused resident comes to the front lobby frequently in their wheelchair. The resident is always asking the same thing (I want to go home and see my mother). Usually the staff get the resident a cup of coffee and take them back to their room. One day I heard the residents familiar voice asking the question of the day (I want to go home to see my mother). I heard an employee say can you hold the door and I will take her for a wheelchair ride outside. This employee did not have to do that. They could have done the usual thing coffee and return them to the unit.
My facility had been going through the process of changing our facility focus which resulted in a sudden drastic reduction in residents. I was faced with the challenge of reducing staff. An employee came to me and told me the they would reduce their hours so their co-worker did not have to. The employee said that their co-worker did not have any other financial support and they did.
My last responsive story is about a maintenance man that is the best one I have ever known. He covers all maintenance duties for a large building that is 35 years old. One day I made rounds and discovered some potential infection control issues. I gave him a list that included replacing a sink and toilet, adding a sink to a utility room, a wall mounted cabinet to a utility room and putting new paper towel holders up in another utility room. I didn't give him the list till lunch time and he got all of it done in a couple of hours. This included going to the store to purchase sinks and cabinets. He also put all new mulch out and planted flowers in the courtyard without being asked.
I have seen many more incidents but these 3 really stood out for me.
Saturday, January 10, 2015
Running An Effective Meeting
Overall effective meeting management can be accomplished when the project manager understands and is capable of effectively executing the following steps:
- Properly Prepare for the Meeting
- Select an Appropriate Location
- Provide Food and Drink
- Provide Necessary Materials
- Establish Working Knowledge of Meeting Topic, Objectives, and Content
- Keep the Meeting Less than an Hour
- Ensure Everyone Gets and Completes Any Pre-Meeting Task
- Help the Group Establish Ground Rules
- Conduct Individual Introductions at Start of Meeting
- Generate and Disseminate an Agenda Prior to the Meeting
- Guide the Discussion without Forcing the Direction
- Close the Meeting with a call for any Remaining Topics that need to be Addressed
- Follow-Up the Meeting with Meeting Minutes that Include Action Items with Agreed Upon Deadlines
Friday, January 9, 2015
Surprise
I went to the Activity Directors office to talk to her one afternoon. Her office is in the activity room and is an opened space. I sat with my back to the room talking to her. She got up and walked out and I picked up an Avon book to look at. Out of the corner of my eye I saw a man come up and get something out of the coat on the back of my chair. I thought it was my maintenance man who I have known for a long time and like to tease. I said "are you trying to touch me" and when he said "no" I knew I was busted. The voice was not who I thought it was. I turned around and it was someone else. The Activity Director was standing there laughing and I quickly said I'm sorry I thought you were someone else and hurried out of the room.
Subscribe to:
Posts (Atom)